Access to healthcare can be difficult all over Western North Carolina - but that’s especially true in the rural parts of the region, where hospitals are far apart and average incomes are lower than in Asheville.
One of thefew free clinics in Western North Carolina is located in Bryson City.
Sarah DeAlto was the first patient at the Swain County Caring Corner - before the building was even finished. Liver problems had been sending her to hospital emergency rooms. DeAlto says the free clinic has kept her healthy while she waits for cirrhosis to overtake her liver.
“I probably would be dead. I hate to say that but I probably would,” says DeAlto. “Because the medication that I’m on right now that I’m on just for my liver is over $500. And if I didn’t have that medication then I wouldn’t be as healthy as I am right now.”
DeAlto says she hasn’t had a full time job in years. But she has racked up over over $35,000 worth of emergency room visits and medications. She met Dr. Frank Van Middlesworth during one of those visits. She now sees Van Middlesworth for free at Swain County Caring Corner, where she says she’s taking less medication and getting regular check ups with a specialist in Charlotte.
Referrals to specialists are of the biggest expenses for the Bryson City clinic, says Ann Edison. She is Dr. Van Middlesworth’s wife and the practice manager who gets their over 200 patients the care they need. Launched in 2015, SCCC provides medicine and treatment through organizations like NCMedassist, DLP, Americares and donations from local organizations.
“I make sure the rules get followed and he’s got the big heart so we’re a good team I think,” says Edison.
The idea for a clinic started when the pair met 20 years ago says Van Middlesworth.
“It took us 16 years to get where we wanted to go to but 4 years ago we got together with some people who had similar ideals and agreed that this country needed a free clinic to help people,” says Van Middlesworth.
Both feel like medical care was a calling. Van Middlesworth quit his job at a pharmaceutical company to go back to go back to medical school when he was 43 years old. Edison says it’s been long road.
“It was good because when one of us didn’t have hope the other one had hope and we have very different approaches so he’s clinic night and I’m day person,” says Edison.
One of the people that they met who shared their vision was Pastor Wayne Dickert of the First United Methodist Church in Bryson City.
“I kept pulling up behind the church at this old run down building in the parking lot and thought ‘this could be something,’” says Dickert.
That building would - after a Duke Endowment grant helped pay for construction - become the Restoration House where SCCC is housed.
“We thought the name “Restoration House” would be perfect because it was this old building that people wanted get rid of - some people just wanted to burn it down - and we wanted to restore it and to restore people’s lives in Swain County, however that would look,” says Dickert. The Duke endowment grant included $55,000 for construction and 3 years of operating funding. That funding ran out at the end of 2018 so the nonprofit is currently searching for new income.
Before the building was finished, patients like DeAlto were seen in a meeting room in the Methodist church which doubled as an exam room.
Restoration House provides its own menu of services including volunteer prayer partners for the clinic. Kathy Proctor says she sees adults whom she taught during her 30-year teaching career almost every night she volunteers at the clinic. At the end of each patient visit, they’re asked if they would like to pray. Proctor says it’s a way to connect with patients and find out what’s on their hearts.
“Something that always strikes me is that when I ask them what they want to pray about it is never about them or their health,” says Proctor.
The team at the clinic says they often figure out what personal stresses are in patient’s lives that could impact their health during the prayer time.
Angelica Franklin has lived in Bryson City for almost her whole life. Franklin hasn’t been able to work since 2011 when she quit her job as a biscuit maker at McDonalds because of her chronic pain. She says she has COPD, seizures and deteriorating lumbar disks in her back because of domestic violence.
“I can’t wash clothes. I can’t cook. And I love to cook. I can’t do flowers anymore. I can’t even hardly see my mom,” says Franklin about her condition. “Nobody should live this way. I’m not but 47 years old. It’s not right in the United States - not just here, anywhere.”
Her partner Tina has been the sole breadwinner for their household. Before she came to Dr. Van Middlesworth, Franklin went without all of her medication. She says she isn’t eligible for Medicaid or disability.
She wonders why Swain County can’t get the same access to services that is available in Asheville.
“It’s a small county, we all was raised here. It’s a good place to raise children,” says Franklin. “Make the time to support Swain county. Then people won’t have to move away to get the help that they need.”
Franklin has only been coming to the clinic for 7 months when BPR spoke with her so she hasn’t seen many significant improvements. Dr. Van Middlesworth wishes healthcare could improve faster in Swain County.
“In 13 years, I haven’t seen a whole lot of change but it’s still the most beautiful place in the world,” says Van Middlesworth.
In 2018, Swain Country dropped to93rd in healthcare out of the state’s 100 counties- even though the percentage of people without health insurance has been declining.
